Abstract
Background
ASD is a challenging condition that influences many areas of life. People diagnosed with ASD are likely to experience difficulties in communication and exhibit behavior disruptions. AT is among the more innovative recent approaches to help children with ASD. AT refers to robotics and interactive technologies, virtual and augmented reality, and games.
Objectives
The aim of this research is to find out the possible effects of AT on the experiences of minors who have been diagnosed with ASD. This paper aims to organize discoveries regarding AT’s impacts on ASD.
Methods
This systematic review was conducted by examining 30 studies out of a total of 100 analyses identified across various electronic databases such as Google Scholar, Scopus, Web, and PubMed, spanning the years 2015 to 2023. The systematic review was conducted through the identification of scholarly articles that examined the application of AT for children diagnosed with ASD.
Results
It was determined that AT is promising for assisting minors who have ASD. For instance, several distinct studies suggest that AT can improve such characteristics as joint attention and turn-taking. The results demonstrate AT to be advantageous, but more comprehensive studies should be conducted.
Conclusion
AT can enhance the standard of living of individuals who struggle with behavioral issues, communication, and social interactions. AT should be utilized more to improve the functioning of minors diagnosed with ASD.
Introduction
Background About Assistive Technology in Health Care
Assistive technology (AT) encompasses a wide range of instruments and systems that are specifically designed to improve the lives and capabilities of those with disabilities. Patients may experience various problems associated with cognitive, physiological, sensory, or neurological disorders, and therefore, they need to develop adaptive care. Accordingly, the use of AT in healthcare has become particularly important as these tools can provide significant improvement for many patients.
In particular, in the context of this term, much attention is paid to the unique needs of people that can be satisfied more efficiently and thoroughly. AT in healthcare can work with many assistive devices, implementing hearing aids, smartphones, and computers, for which special software has been created. Anxiously bridging the ability gap between individuals with and without impairments is the objective of AT. Providing opportunities for children with autism to adapt to their environment can help improve their independence and well-being.
In healthcare, AT is aimed at tailoring it as closely as possible to a specific person. This requires collecting certain information that can help in making an adapted version of the program. The use of advanced technologies and communication devices is an integral part of AT since another principle of this approach is the combination of several auxiliary means. This recognizes the fact that disabilities can be very diverse and unique, and therefore, in healthcare, it is crucial to comply with all patient requirements. Embracing inclusivity and diversity can have a positive impact on how care professionals and health service providers deliver care. Personalizing the products and services provided through the AT model can increase the likelihood that the efforts undertaken will work as efficiently as possible.
Introduction to the Use of Assistive Technology in ASD Therapy
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition distinguished by a diverse array of symptoms, including communication and social behavior impairments, as well as obstacles that impact the social interaction, communication, and conduct of an individual. While some individuals with ASD may exhibit few symptoms and maintain a considerable degree of independence, others may necessitate substantial assistance and supervision. The challenges posed by ASD are more evident among the younger population.
According to the WHO, the prevalence of ASD has increased gradually on a global scale. Autism spectrum disorder (ASD) was estimated to affect around 1 in 36 children in the United States in 2020, according to the Autism and Developmental Disabilities Monitoring (ADDM) Network of the Centers for Disease Control and Prevention (CDC). Recently, the prevalence of ASD in Qatari children was estimated to be 1.1%. The use of AT may be helpful in helping children with ASD since supportive resources are one of the central themes in relation to reducing the impact of the condition.
The potential for AT utilization is associated with how the approach addresses ASD symptoms. A specific effect of the disease on children is that their cognitive abilities may be overly focused on specific topics that interest them. In addition, children may be afraid and avoid touch contact as it may be unpleasant for them. Using AT methods to overcome such negative consequences can help people with ASD be more comfortable in society and interact with other people. For example, AT technologies can allow children to express their thoughts in a minimally verbal way so that this process is as convenient and acceptable for them as possible.
ASD therapy may incorporate robotic and interactive technologies to provide structured interventions. This allows one to track progress in relation to the manifestation of symptoms so that personnel can adjust their care and pay more attention to those aspects that remain quite progressive. In this context, the use of advanced care tools can provide significant support as they are able to provide a detailed analysis of the disease. Because autism is occasionally linked with severe social impairment, there may be occasions in therapy where the use of assistive technologies becomes essential. Thus, studying the use of AT in the treatment of ASD may increase understanding of the provision of health care for this disorder.
Traditional Approach
Educational Interventions for Autism
Treatment for autism includes several approaches that are aimed at helping and treating symptoms in people who have ASD. The methods to improve their various skills and adapt to their environment. One conventional approach involves educational therapies aimed at enhancing social, communication, and learning skills in individuals diagnosed with autism spectrum disorder (ASD). These strategies have the capacity to greatly enhance the quality of life of an individual and facilitate the realization of their utmost capabilities. These interventions are specifically formulated to address the distinct educational requirements of individuals with autism and foster their holistic growth.
Nowadays, one of the most widely acknowledged educational approaches to autism is Applied Behavior Analysis (ABA), which focuses on increasing desirable behavioral skills and decreasing undesirable or problematic ones. This science-based approach breaks down complex skills into smaller, manageable units and teaches them systematically. During treatment, therapists use systematic assessment and positive reinforcement to achieve goals. In general, ABA demonstrates significant efficacy in addressing various skill deficiencies, encompassing communication, social interaction, and daily life, owing to its ability to adapt to individual requirements. Nonetheless, this approach is not the only treatment option for autism, as other educational interventions exist.
An alternative to ABA is the usage of structured learning, which is often associated with the TEACCH (Treatment and Education of Autistic and Related Communication-handicapped Children) program. Structured learning involves creating visual schedules, a structured work environment, and clear daily routines to help people with autism better understand and navigate their daily activities. Such an approach is constructive for people who enjoy visual support and clear, predictable routines, helping them reduce anxiety and promote independence in daily tasks.
Behavioral Interventions for Autism
Among the most common and effective methods of traditional ASD treatment are behavioral interventions. Their emphasis is on cultivating learning, communication, and, consequently, social skills in individuals with autism. While ABA can be viewed as a behavioral intervention, there are alternative approaches that target specific features of behavior associated with autism.
One such method is the application of social stories. Social stories, which Carol Gray created, are concise narratives that employ visual and organized elements to depict social events and acceptable conduct. They help autistic people understand social cues, expectations, and responses in different social contexts. Moreover, social stories are separately adapted to each individual’s specific needs. Furthermore, the range of places where stories can be used is extensive and can include teaching at home or at school, as well as in specialized programs for children with autism.
In general, stories can cover a wide range of social situations, ranging from everyday moments such as chatting and greeting to more complex scenarios, for instance, changes in routine, moving, or doctor’s visits. However, it is crucial that they are simple, specific, and understandable and focus on explaining the rules and expectations in social situations. Thus, this behavioral approach can be an effective tool for teaching communication skills or increasing adaptive skills. They improve the comprehension and anticipation of social circumstances for autistic children and adults, influencing their interactions and, consequently, their level of social engagement.
Other Traditional Approaches
Aside from educational and behavioral interventions, other equally effective traditional approaches have been extensively applied for ASD. For instance, the objective of speech and language therapy is to develop children’s communication abilities, thereby substantially improving their capacity to interact with others across many life circumstances.
In particular, it addresses difficulties with expressive and receptive language, allowing autistic people to express their needs better and understand others. For instance, they may have trouble with word pronunciation, grammar, and expanding their vocabulary. Speech therapists help those diagnosed with ASD develop these skills, allowing the individuals to express their thoughts and yearnings. Consequently, the efficacy of communication improves, and challenges in forming social interactions or engaging in conversations may be substituted with the capability to initiate and sustain dialogue.
Furthermore, traditional approaches to treating autism spectrum disorders may focus on improving sensory processing and fine motor skills. Many people with autism have sensory sensitivity or difficulty processing sensory information, which can lead to problems with daily activities and interactions. Occupational therapists use a combination of structured exercises, activities, and adaptive techniques to better fine motor skills. For instance, specific approaches may concentrate on dexterity or hand-eye coordination.
Therefore, occupational therapy helps people with autism create the necessary skills to perform tasks such as writing, dressing, and self-care. Thus, traditional approaches to autism include various ways of helping to address specific challenges of people with ASD. That is, the most crucial part of these conventional approaches is individualization, as each person with autism is unique and can benefit from a combination of interventions to achieve their full potential.
Intelligence Techniques for Autism
Assistive Technologies
Intelligence techniques for autism include the use of communication devices, social skills apps, and sensory integration devices. These technologies aim to support individuals with autism in developing social communication skills, improving social interactions, and addressing sensory challenges. Research has shown the efficacy of these techniques in various contexts. A study conducted in the United Kingdom examined the educational efficacy of an academic environment where autistic children engaged in social interactions with an artificially intelligent virtual agent. The results revealed that the children demonstrated increased social responses and initiated interactions with human practitioners.
Similarly, positive outcomes were noted in the evaluation of an intelligent ecosystem in another study that employed ontologies and robotic assistants to support the enhancement of social communication skills in children with autism. Additionally, wearable technology designed to assist social interactions in autistic individuals has been developed, with its promise and limitations noted for future research. Furthermore, the implementation of wearable sensors and machine learning methodologies has yielded encouraging outcomes in the identification of problematic behaviors exhibited by children diagnosed with autism when engaging with social robots and toys. Moreover, it has been found that employing smart boards enhances the social communication and interaction abilities of children with autism.
Robotics and Interactive Technologies
Artificial intelligence techniques, such as robotics, interactive technologies like social robots, and immersive experiences through virtual environments, augmented reality (AR), and gaming applications, have been utilized in the context of autism. These technologies have been used for various purposes, such as diagnostic evaluation, social interaction skills training, perception-motor development, and metacognitive skills training. Studies have shown that artificial intelligence robots can be effective in diagnosing autism spectrum disorder (ASD) and detecting turn-taking deficits in children with ASD.
Assisting individuals with ASD, interventions based on technology, such as computer-assisted systems, computer vision-assisted technologies, and interventions incorporating virtual reality or artificial intelligence, have shown potential. Nevertheless, further research and standardization are necessary. In general, these technologies possess the capacity to enhance the identification, management, and instruction of those who have ASD.
Methodology
Recent scholarly articles and conference proceedings pertaining to the application of assistive technology, particularly robotics, in autism therapy constituted the subject of this investigation. The search, conducted in electronic databases such as Web of Science, Scopus, Google Scholar, and PubMed, involved looking for keywords like “assistive technology,” autism,” “robot,” “robotics,” “ASD” and we specifically combined “‘autism’ AND ‘robotics,’” “‘autism’ AND ‘assistive technology,’” “‘ASD’ AND ‘robotics’” in titles, keywords, and abstracts.
One hundred studies were identified. Inclusion criteria comprised studies as follows:
- Studies with objectives related to the main aim of this review, ‘improving the life quality of children with ASD;
- Studies using one or more assistive technology;
- Studies conducting experiments or evaluations on participants.
Duplicate studies were removed, and non-related studies were excluded through a thorough classification and filtering process based on titles, abstracts, and contents. Ultimately, 30 studies met all inclusion and exclusion criteria.
Subsequently, the eligibility criteria for evaluating the research papers’ study quality were established. Incorporating studies that investigate the effectiveness or ineffectiveness of robots in enhancing the level of life for pediatric patients diagnosed with ASD is necessary. We excluded research articles focused solely on the development of a robotic tool without assessing its effectiveness in improving the quality of life for children with ASD. Research papers that failed to provide any data, thorough analyses, or age information for participants were eliminated. Additionally, research that exclusively included adults with ASD was also excluded. A flowchart, designed following PRISMA guidelines, a set of evidence-based essentials for systematic review reporting, is presented in Figure 1.
Results
Discussion
Following the application of the inclusion and exclusion criteria and the elimination of duplicates, a final count of 30 studies (N = 30) remained. The aforementioned articles were chosen for an exhaustive examination. The research was conducted between the years 2015 and 2023. The studies discovered in this review are categorized in Table 1. The classification includes the following information: study reference number, year of publication, number of participants (including ages and ages), robots utilized in each research, study aims, and findings.
Additionally, a statistical analysis has been performed to illustrate specific patterns in the evaluated inquiries. The number of published publications concerning the use of assistive technology to enhance the quality of life for children with ASD is depicted in Graph 1. The frequency with which professionals review the use of AT for children diagnosed with ASD seems to be disproportionate. The most significant number of scholarly assessments on the subject was eight in 2019, which is the most considerable number to date; by 2023, there will be only two. This observation implies that children with ASD would not receive significant attention, and although improved assistive technology has been developed, it has not yet undergone testing.
Furthermore, Graph 2 illustrates the number of reports that highlight positive impacts identified in the evaluated studies, which may have an association with quality of life. The bulk of the publications that were analyzed indicate that AT is advantageous for children with ASD across various domains, such as turn-taking, joint attention, and vocalization, among others. However, certain limitations that warrant additional research have been observed. As an illustration, the authors of one article that illustrates the overall efficacy of AT mention that participants were more attentive to the robot than to the therapist.
Another study indicates that the favorable effects may not persist over a prolonged period. Consequently, the findings imply that children with ASD may witness an enhancement in their quality of life through the acquisition of additional abilities and skills. Therefore, the utilization of AT is quite promising, but further comprehensive professional research is needed.
Future Directions and Recommendations
Based on the above-discussed statistical analysis, research gaps and areas for further investigation can be proposed. First, studies that have already been conducted may lack follow-ups with participants to track the results’ stability. Second, there has been an insufficiency in the recent examinations. Accordingly, additional exploration of the latest AT should be accomplished with the effects oriented for the long term and in a broader group of children with ASD.
The current report offers some practical implications for professionals and caregivers. On the one hand, experts who work with children with ASD can learn more about the application of AT. For example, specialists who already use AT should remember that while being practical, technology cannot fully replace human interaction. Professionals who are wary of AT should read the above-listed articles to gain a better comprehension of the method and its potential for assisting ASD-diagnosed children. On the other hand, the guardians of underage ASD individuals should consider engaging minors in groups that utilize AT for better recognition of emotions and enhanced communication. Accordingly, the implications of this report are that it can improve understanding of AT and spread awareness of the subject.
There are also some policy recommendations for integrating intelligent techniques and devices. First, AT should be commonly advised for use with children who have ASD. Second, decision-makers should encourage and invest in advancing the creation and research of AT to ensure that its effects are well understood and better approaches are devised. Third, feedback from ASD children engaged with AT should be gathered and analyzed to determine the changes that should be implemented. Overall, a comprehensive policy should be developed by people in power to help the younger population with ASD and those around them.
Conclusion
To summarize, AT offers opportunities for better experiences by enhancing individuals’ well-being and level of independence. The present report has observed many studies on the AT application with children who have ASD and closely examined 30 different pieces of research on the matter. The findings demonstrate that AT can be beneficial for children due to improving skills and competencies such as attention span, emotion recognition, and communication.
The report’s implications are that caregivers and professionals should consider using AT to assist children. Future research should concentrate on more comprehensive analyses focusing on the prolonged effects of AT and the latest developments in AT. Assistive technology is quite promising for ASD-diagnosed children, who must not be overlooked by society.
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